The following is a handout Hornsey & Wood Green Health & Care Group distributed at the Labour Party Conference in September 2022.
Primary care: a better future
Britain should be proud of the NHS, and nurse it back to health
Shameful Tory legacy
- 12 years of underfunding mean patients face life threatening waits for GP appointments, ambulances, A&E and hospital referrals.
- Over 6.5 million patients are waiting for surgery.
- Demand for primary care is up because of Covid delays, high levels of chronic disease, rising inequalities, falling average life expectancy, too few hospital beds and inadequate social care.
- Primary care staff are quitting faster than they can be recruited, retiring early/working part- time because they’re overworked and exhausted.
- We are 6000 GPs and 26,000 other primary care staff short.
- Inter -country comparisons: UK ranks 29th for doctors, 22nd for nurses/ 1000 population, 24th for life expectancy at 65 years, 12th for % GDP health spend (OECD), and 32nd for hospital beds.
Why prioritise primary care?
- Primary care is the most inclusive, equitable and cost-effective approach to improving people’s physical and mental health (WHO 2021).
- Primary care is responsible for 90% of all patient contacts but yet it receives only 9% of NHS spend, lower than the average, (14%), of comparable OECD countries.*
What a new government should do
- Pledge to fix the crisis AND re-build primary care fit for the 21st century, patient designed and focused, prioritising continuity of care (it saves lives), embedded in communities and central to an NHS focused on prevention. It will operate as local, one -stop centres, part of health and wellbeing hubs, providing health promotion, preventive, medical and some outpatient services, in partnership with social care, hospitals, public health, and the voluntary sector. Rollout innovative, good practice primary care models, and evaluate.
- Fix workforce: fund enough doctors and nurses to keep the NHS safe. Drive rapid recruitment, training, returnees, and retention programme, (attract and facilitate returnees/retirees on flexible terms), deliver additional university and practice-based training places, reinstate adequate nurse bursaries. Review workforce strategy annually.
- Fix workload: reduce unnecessary bureaucracy and administration -support Primary Care Networks and larger practices to assist others with back-office functions, e.g. HR and premises, enable improved use of IT for administrative tasks, introduce NHS terms for all primary care staff, end task shifting by hospitals to primary care, and review inspection arrangements (CQC and QoF).
- End wasteful privatisation: stop award of new private Alternative Provider of Medical Services (APMS) contracts, paid 14% more per patient than NHS General Medical Service (GMS) contracts. APMS contracts often deliver poorer patient satisfaction and are sometimes terminated by companies disappointed with profit levels. Support new salaried practice models with PCN/ Federation/ICS held contracts and explore Employee Ownership Trust model. (Somerset).
- Increase primary care funding to at least the OECD average*, targeting additional funds, initially to NHS practices in under-doctored areas. Healthy countries are economically efficient ones, so raise NHS spend (as a percentage of GDP), to the level of comparable countries. This may take several parliamentary terms.
- Increase GP and patient representation in Integrated Care Systems.
- Invest in community nursing, social care, hospitals, public health, dentistry, end of life care.
Hornsey & Wood Green CLP Health & Care Group, Haringey KONP